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Visual attention during non-immersive virtual reality balance training in older adults with mild to moderate cognitive impairment: an eye-tracking study

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dc.contributor.authorMaldonado, Marcos
dc.contributor.authorJara, Gonzalo
dc.contributor.authorGonzález Seguel, Felipe
dc.date.accessioned2026-07-21T20:14:02Z
dc.date.available2026-07-21T20:14:02Z
dc.date.issued2025
dc.description.abstractBackground: Older adults with cognitive impairment often present with balance deficits, reduced walking speed, and attentional difficulties-particularly in executive function. These challenges increase fall risk and complicate traditional rehabilitation approaches. Eye-tracking technology offers an objective way to evaluate attention by analyzing oculomotor behavior during tasks, but its use in clinical rehabilitation contexts is still limited. Objective: The aim of this study is to investigate visual attention using eye-tracking metrics during a non-immersive virtual reality-based balance training program in older adults with mild to moderate cognitive impairment. Methods: This was an exploratory pilot study with a prospective, descriptive cohort, based on a non-controlled, quasi-experimental design of seven older adults with mild to moderate cognitive impairment. Each patient underwent VR-based balance training using RehametricsⓇ software, while their attention was assessed via eye-tracking (Tobii Pro Glasses 2 Refurbished Wireless). Clinical assessments included the Mini-BESTest, Functional Gait Assessment, 6-Minute Walk Test, 4-Meter Walk Test, and Montreal Cognitive Assessment (MoCA). Eye-tracking data focused on fixation patterns, microsaccades, and pupil diameter as indicators of attentional processing. Results: Patients showed a small numerical increase, without reaching statistical significance in task difficulty progression (p = 0.016), lower limb endurance (p = 0.016), and single-leg support time (p = 0.031). Clinical tests revealed a slight increase, though results were not statistically significant in balance and walking speed (p = 0.063). Eye-tracking data indicated increased fixation stability and decreased pupil diameter, suggesting more efficient attention allocation during motor tasks. Conclusions: Eye-tracking provided valuable metrics into attentional behavior during balance training in older adults with cognitive impairment. Its integration into non-immersive virtual reality rehabilitation may help better understand and address cognitive-motor interactions. Further studies with larger samples are needed to confirm these preliminary findings.
dc.description.versionVersión Publicada
dc.identifier.citationMaldonado-Díaz M, Jara-Vargas G, González-Seguel F. Visual attention during non-immersive virtual reality balance training in older adults with mild to moderate cognitive impairment: an eye-tracking study. Front Aging Neurosci. 2025 Oct 21;17:1671477. doi: 10.3389/fnagi.2025.1671477
dc.identifier.doihttps://doi.org/10.3389/fnagi.2025.1671477
dc.identifier.urihttps://hdl.handle.net/11447/10884
dc.language.isoen
dc.subjectAttention
dc.subjectBalance training
dc.subjectCognitive impairment
dc.subjectEye-tracking
dc.subjectOlder adults
dc.subjectVirtual reality
dc.titleVisual attention during non-immersive virtual reality balance training in older adults with mild to moderate cognitive impairment: an eye-tracking study
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceFrontiers in aging neuroscience
dspace.entity.typePublication
relation.isAuthorOfPublication507eb05b-daec-4369-9b2c-ce63a17a6844
relation.isAuthorOfPublication.latestForDiscovery507eb05b-daec-4369-9b2c-ce63a17a6844

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